Society of Cardiovascular Angiography and intervention Stage-B cardiogenic shock: An interventional-heart failure-critical care conundrum

Figures

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  Fig. 1.. Clinical Case 1 Electrocardiogram (A), coronary angiogram (pre [B] and post[C] percutaneous coronary intervention), and echocardiogram (D) demonstrating anterior ST-segment elevation myocardial infarction with evidence of mid-left anterior descending artery thrombotic occlusion and severe mitral regurgitation without ischemic leaflet tethering.

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  Fig. 2.. Clinical Case 2 Electrocardiogram (A), echocardiogram (B) coronary angiogram (pre [C] and post[D] percutaneous coronary intervention along with the presence of left ventricular assist device [Impella]), and echocardiogram (E) demonstrating anterior ST-segment elevation myocardial infarction with evidence of proximal left anterior descending artery thrombotic occlusion and normal left ventricular systolic function.

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  Fig. 3.. Clinical Case 3 Electrocardiogram (A), coronary angiogram (pre [B] and post[C] percutaneous coronary intervention along with the presence of left ventricular assist device [Impella]), and echocardiogram (D) demonstrating anterior ST-segment elevation myocardial infarction with evidence of proximal left anterior descending artery thrombotic occlusion and decreased left ventricular systolic function.

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  Fig. 4.. Clinical Case 4 Electrocardiogram (A), coronary angiogram (pre [B] and post[C] percutaneous coronary intervention), and echocardiogram (D) demonstrating anterior ST-segment elevation myocardial infarction with evidence of proximal left anterior descending artery thrombotic occlusion, decreased left ventricular systolic function, and apical mural thrombosis. Repeat electrocardiogram (E) on day 3 demonstrating antero-lateral ST-segment-elevation. Repeat coronary angiography demonstrating sub-acute stent thrombosis of proximal left anterior descending artery stent (F) needing repeat balloon angioplasty (G) and aspiration thrombectomy demonstrating coronary thrombus (H). Subsequent stabilization of cardiogenic shock using TandemHeart ® percutaneous left ventricular assist device (I).